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My Mom’s in ICU for Months with Stroke, She’s Stuck on the Ventilator & Tracheostomy, We Want Her Home

Hi, it’s Patrik Hutzel from intensivecareathome.com where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies at home and where we also provide tailor-made solutions for hospitals and intensive care units at home whilst providing quality care for long-term ventilated adults and children with tracheostomies at home, otherwise medically complex adults and children at home, which includes Home BIPAP (Bilevel Positive Airway Pressure), Home CPAP (Continuous Positive Airway Pressure), home tracheostomy care for adults and children that are not ventilated, Home TPN (Total Parenteral Nutrition), home IV potassium infusions, home IV magnesium infusions, as well as home IV antibiotics. We also provide port management, central line management, PICC (Peripherally Inserted Central Catheter) line management as well as Hickman’s line management and we also provide palliative care services at home.

We’re also sending our critical care nurses into the home for emergency bypass services as we have done so successfully for the Western Sydney Local Area Health District, their in-touch program. We basically cut the cost of an intensive care bed by 50%. By avoiding emergency department admissions, we’re roughly saving $2,000 per ED admission that we are avoiding.

Now today, I actually want to look at a client that we are in the process of assessing for home care. I want to talk more about the medical history so that families, patients, but also, health professionals understand our capabilities for home care. So, this is actually a lady in her 70s who’s got a history of focal motor seizure, acute respiratory failure. She’s got apnea, she’s got a history of subarachnoid hemorrhages, she’s got renal impairment, and she’s got coronary artery disease. So, she’s been stuck in ICU for months on end.

“She still has a high white cell count…”

I’m just reading out the medical report here:

“…but white cell count is improving, and it’s decreased from 19.7 to 17.1. The CRP (C-reactive protein) is still high as well but also decreasing.”

Again, white cell count and CRP are signs of infection markers. This is the issue in ICU that patients are much more prone to an infection than they are in a home care environment because ICUs are “dirty,” which means they are full of infections, full of bacteria, full of virus. As soon as you take a patient out of ICU, they’re much less prone to infections, especially when patients are tied to a ventilator. This lady is in respiratory failure and can’t come off the ventilator.

The report continues:

“The arterial blood gas was done on the 9/16/2024 which was adequate. The recent CT chest showed mild basilar atelectatic changes, but no definite infiltrates were noted. The patient cannot be weaned off the ventilator. She becomes apneic (stops breathing) and takes a few shallow breaths which is more due to central neurological problems. The ICU doctors advised to continue the current management.

The vital signs of the patient are acceptable, within the normal ranges except for high blood pressure readings of 183/101 and 184/93. Temperature is 36.4 °C. Heart rate is 76. Blood pressure and oxygen saturation, 100%. The patient is on medications for her high blood pressure such as hydralazine, 10 mg, 0.5 mls, IV Push, every 4 hours as needed (PRN), Amlodipine 5 mg oral tablet.

We continue observing and monitoring her and report to the doctors for early warning signs, abnormal changes in the patient’s behavior, level of consciousness, persistent elevation or low blood pressure, heart rate, and other vital parameters for rapid interventions and management.

Hemoglobin and hematocrit are stable. Sodium is 145. Potassium is 3.6. Chloride is 110. Carbon dioxide is normal. BUN (blood urea nitrogen) is high. Alkaline phosphatase is normal. AST, ALT, glucose, creatinine, all normal. Albumin is 3.46. It’s a little bit on the low side. Magnesium is normal and medications the patient is on are atorvastatin, atropine is needed, Dulcolax laxative, DuoNeb, Keppra, lactulose, lansoprazole, magnesium sulfate, potassium chloride, scopolamine, Tylenol, valproic acid, vancomycin, Vimpat, zinc oxide.”

So, these are all things that can be done at home. There’s absolutely no need to stay in intensive care at this particular point in time. It’s simply that after weeks and months in ICU and having shown the inability to be weaned off the ventilator and departments of health insurance is paying $5,000 to $6000 per bed day whilst having the inability to use this intensive care bed for other patients in need of higher acuity critical care, it only makes sense that patients and families finally can go home. Because we know from this family, they’re spending day and night in ICU, and they would be so much better off at home. It is just common sense to free up the bed, cut the cost by 50%, free up the staff in ICU as well, and get the bed used for surgical patients or patients that have come through the emergency department or the emergency rooms and so forth.

So, with Intensive Care at Home, we are currently operating all around Australia in all major capital cities as well as all regional and rural areas. We are a NDIS (National Disability Insurance Scheme) approved service provider in Australia, TAC (Transport Accident Commission) and WorkSafe in Victoria, iCare in New South Wales, NIISQ (National Injury Insurance Scheme) in Queensland, as well as DVA (Department of Veteran Affairs) all around the country. Our clients also receive funding through public hospitals, private health funds as well as departments of health.

We are the only provider in Australia in 2024 that has achieved third-party accreditation for Intensive Care at Home nursing. No other provider has created this much intellectual property for Intensive Care at Home nursing than we have. We are therefore employing hundreds of years of intensive care and critical care nursing experience combined in the community. No other provider brings that level of expertise in the community than we do.

If you’re at home already or you are stuck in ICU, that like the example that I gave today. You’re stuck in ICU on a ventilator, tracheostomy, BIPAP, CPAP, Home TPN, whatever the case may be, and you realize that your current setup is not working, or you are stuck in ICU and you want to go home, you’re wondering whether it’s all possible, I can assure you it is. Then, I encourage you to reach out to us here at intensivecareathome.com. Call us on one of the numbers on the top of our website or send us an email to info@intensivecareathome.com.

The reality is that, in order to go home on a ventilator with a tracheostomy, you must have intensive care or critical care nurses 24 hours a day as is evidence based as per the Mechanical Home Ventilation Guidelines that we publish on our website. Just on one of my recent videos, I mentioned that we have been made aware that another client in the community passed away because they didn’t have critical care nurses 24 hours a day.

Support workers, once again, didn’t know how to manage medical emergency on a ventilator with the tracheostomy. It is absolute madness to let support workers look after an intensive care patient. That is absolute and utter madness, and it needs to stop. Funding bodies, including the NDIS, need to be held accountable for it before more damage is done and before more patients are dying.

If you are at home already and you think you don’t have enough funding, don’t worry about it. We can help you with funding, otherwise we wouldn’t be in business. The NDIS and other funding bodies do fund 24-hour critical care nurses. It just comes down to the right level of advocacy which leads me that we’re also providing Level 2 and Level 3 NDIS Support Coordination. Our NDIS support coordinator is Amanda Riches and her team and I’ve put a link to Amanda’s interview that I’ve done in the written version of this blog and you can watch the video there. We also have Rosie Hammer in New South Wales. We also provide TAC case management in Victoria.

If you’re a NDIS support coordinator and you are watching this, and you’re looking for nursing care for your participants, please reach out to us as well. If you’re looking for more funding, for more nursing care for your participants, and you don’t know how to go about it and what evidence to provide, I also encourage you to reach out to us. We can help you with the advocacy and we also provide NDIS specialist nursing assessments done by critical care nurses with a legal nurse consultancy background.

If you are a critical care nurse and you’re looking for a career change, we’re currently offering jobs for critical care nurses in the home in Melbourne, Sydney, Brisbane, in Albury, Wodonga, in Bendigo in Victoria, as well as in Warragul in Victoria, and in Geelong in Victoria. If you have worked in critical care for a minimum of two years pediatric ICU, ED, and you have already completed a postgraduate critical care qualification, we will be delighted to hear from you.

I have a disclaimer though because we are offering a tailor-made solution for our clients, which includes regular staff. Our clients want the same staff coming over and over again because they are so vulnerable and so special. It’s all about building critical relationships with our clients and with our team members and having regular and stable teams. That means, if you are looking for casual or agency work where you can come and go, Intensive Care at Home may not be the right fit for you on a long-term basis because our clients want the same staff over and over again. So, it’s all about building those critical relationships with our clients and their families and we want to build relationships with you as well, of course, so that it remains a win-win situation.

If you are an intensive care specialist or an ED specialist, we also want to hear from you. We are currently expanding our medical team as well.

We can also help you eliminate your bed blocks in ICU, ED for long-term patients or for your regular readmitted patients. We’re here to help you to take the pressure off your ICU and ED beds, and in most cases, you won’t even pay for it.

If you’re a hospital executive watching this and you have bed blocks in your ICU, ED, and respiratory wards, please reach out to us as well. We can help you.

Lastly, if you’re in the U.S. or in the U.K. and you’re watching this, and you need help, we want to hear from you as well. We can help you there privately.

Once again, contact us at intensivecareathome.com. Call us on one of the numbers on the top of our website or simply send us an email to info@intensivecareathome.com.

If you like my video, subscribe to my YouTube channel for regular updates for families with Intensive Care at Home and intensive care. Click the like button, click the notification bell, share this video with your friends and families, and comment below what you want to see next, what questions and insights you have from this video.

I also do a weekly YouTube live where I answer your questions live on the show and you will get notification for the YouTube live if you are a subscriber to my YouTube channel, or if you are a subscriber to our email newsletter at intensivecareathome.com.

Thank you so much for watching.

This is Patrik Hutzel from intensivecareathome.com and I will talk to you in a few days.

Take care for now.